Endoscopic therapy for Barrett's oesophagus

Abstract Barrett's oesophagus (BO) is thought to progress through the development of dysplasia (low grade and high grade) to oesophageal adenocarcinoma, a lethal cancer with poor survival. The overall goal of endoscopic therapy of BO is to eliminate metaplastic and dysplastic epithelium, to pre...

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Bibliographic Details
Published in:Baillière's best practice & research. Clinical gastroenterology 2015-02, Vol.29 (1), p.167-177
Main Authors: Blevins, Christopher H., MD, Iyer, Prasad G., MD, MS, FASGE, FACG
Format: Article
Language:English
Subjects:
Adenocarcinoma - prevention & control
Barrett Esophagus - surgery
Barrett's Oesophagus
Biopsy
Cryotherapy
Disease Progression
Dissection
Endoscopic mucosal resection
Endoscopic submucosal dissection
Endoscopy
Endotherapy
Esophageal Neoplasms - prevention & control
Esophagoscopy - methods
Gastroenterology and Hepatology
Humans
Medical imaging
Oesophageal adenocarcinoma
Precancerous Conditions - surgery
Radiofrequency ablation
Surveillance
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Summary:Abstract Barrett's oesophagus (BO) is thought to progress through the development of dysplasia (low grade and high grade) to oesophageal adenocarcinoma, a lethal cancer with poor survival. The overall goal of endoscopic therapy of BO is to eliminate metaplastic and dysplastic epithelium, to prevent and/or reduce the risk of progression to OAC. Endoscopic therapy techniques can be divided into two broad complementary techniques: tissue acquiring (endoscopic mucosal resection and endoscopic submucosal dissection) and ablative. Endoscopic therapy has been established as safe and effective for the subjects with intra-mucosal cancer (IMC), high-grade dysplasia (HGD) and more recently in treating low-grade dysplasia (LGD). Challenges to endoscopic therapy are being recognized, such as incomplete response and recurrence. While eradication of intestinal metaplasia is the immediate goal of endoscopic therapy, surveillance must continue after complete elimination of intestinal metaplasia, to detect and treat recurrences.
ISSN:1521-6918
1532-1916
DOI:10.1016/j.bpg.2014.11.007